A Conversation About Infertility: Expert Answers to Common Questions

The week of April 23rd through the 29th officially marks National Infertility Awareness Week®, a much-needed initiative aimed at promoting greater awareness about infertility. While infertility is simply defined as an inability to conceive or “get pregnant”, the coexisting emotional ups and downs and often overwhelming feelings of helplessness and hopelessness are just as simply indescribable.

Despite all the wives’ tales, unsolicited advice and general hearsay that’s often to the contrary, infertility isn’t always a result of your doing something “wrong” and others doing something “right”.

I’ve been pregnant a total of five times.

My first, and only viable pregnancy thus far, resulted in the birth of a beautiful 9-pound, 6-ounce baby boy. My second, third and fourth pregnancies resulted in miscarriages, each of which was ultimately linked to the presence of fibroids. The last one turned out to be an ectopic (tubal) pregnancy that resulted in a salpingectomy during which one of my Fallopian tubes was permanently removed.

After having lost four pregnancies, consecutively, the sporadic waves of pain and anguish was, and still, is very real. But, so is my ability to embrace the possibility of only having one child.

Prior to my ectopic pregnancy, I didn’t embrace the word or even the idea of “infertility”.

Sure, I knew it was possible, but I would never entertain the remotest idea of it directly affecting my ability to get pregnant? And, up to my having experienced a tubal pregnancy, infertility wasn’t really an issue. I had given birth to a perfectly healthy boy after which I was able to conceive three times in less than two years—The first of the three being triplets.

Infertile? No, not me!

Since these “unviable” pregnancies were linked to fibroids, I simply underwent a myomectomy to have them removed and was once again able to conceive.

But, my “fertile mertile” tale stops there.

So, does my utterly ignoring the possible idea of infertility.

Since undergoing the salpingectomy procedure I haven’t been able to conceive. I’m not at all an anomaly either. According to the CDC, one in eight couples in the US experience infertility and it’s been reported that infertility affects 45 million couples worldwide.

I can certainly relate to every woman (and man) who’s battling it out, both physically and emotionally. Fortunately, I’ve found solace in sharing my personal experiences with others and doing so has been one of the best forms of mental therapy. I also find comfort in knowing that fertility treatment options are available if I so wish to go that route.

In honor of National Infertility Awareness Week®, now’s a good time to have a real discussion about just what causes infertility and what can be done about it.

I’ve turned to Christopher S. Sipe, MD with Fertility Centers of Illinois, who’s so graciously shared his experiences and expertise on the topic. After trying unsuccessfully to conceive on their own, patients walk through their doors with a lot of questions. To help others and shed light on infertility, he’s shared the 10 most common questions they hear.

I encourage you to read on, as some of his answers may very well surprise you.

“Why can’t pregnancy happen ‘naturally’?”

This can happen due to one issue or several. For example, factors including medical diagnoses, lifestyle habits, cancer treatment, prescription medication and excess body weight can make conception a challenge. In other cases, the cause of infertility is unexplained. For women, common infertility issues can include ovulatory disorders, poor ovarian reserve, PCOS, endometriosis, or fibroids. For men, hormonal imbalances and semen issues are common infertility diagnoses.

“Am I too old?”

With age, the quantity of healthy eggs decline and perimenopausal hormone changes begin, making conception and pregnancy difficult. It is also important to note that the most common pregnancy outcome at any age is a healthy baby. As men age, the prevalence of obesity, diabetes, cardiovascular disease, and high blood pressure increases. Both these health issues and the prescribed medicine used to treat them can cause infertility.

“Is pregnancy loss rare?”

Pregnancy loss is very common with half of all pregnancies resulting in a loss, and most losses occurring before a woman misses her period. Of all known pregnancies, 15-25% will result in a loss.

“Is infertility uncommon?”

One in eight couples experience difficulty in achieving or sustaining a pregnancy. The odds are that you know several people who have experienced fertility challenges.

“What are the risks and side effects of treatment?”

Overstimulation of the ovaries is the main risk of treatment, which is why regular ultrasound monitoring is required during the stimulation phase. To assess stimulation response, patients undergo ultrasound monitoring daily or every other day.

“Are we having problems because we are ‘missing’ the fertility window?”

Trying for a baby must occur preceding or during ovulation in order for pregnancy to occur. To pinpoint the timing for ovulation, it is helpful to use an ovulation prediction kit or log menstrual cycles. Getting help shouldn’t happen right away—couples where the woman is under 35 should try for one year before seeing a physician, and couples with a woman over 35 should try for six months prior to medical assistance.

“What are the costs involved?”

Costs will vary based upon insurance coverage, where a patient lives and state mandates. The average out-of-pocket cost of an IVF cycle is $10,000-12,000 including medication. To defray costs, patients can enroll in a medical study or apply for a grant through the Kevin J. Lederer LIFE Foundation or CADE Foundation. Self-pay patients also receive discounted services, and physicians may have access to discounted medicine.

“What are my chances of success?”

There is no magic answer that will fit everyone. The chances of success will vary widely based upon age, medical diagnosis and previous medical and treatment history. Your physician should be able to discuss your personal odds of conception after a detailed assessment.

“What does my insurance cover?”

Again, this will vary based upon individual insurance plans and state law. Illinois mandates fertility coverage, but this is limited to employers headquartered in Illinois with at least 25 employees. To confirm coverage, ask your benefits department whether your employer is self-insured or exempt from fertility coverage, then confirm specific coverage with your insurance company.

“How much time do I have to take off?”

You will need to take very little time off or none at all. Monitoring appointments are short and can occur prior to working hours. An IUI procedure, egg retrieval or embryo transfer can be scheduled on a weekend, but may require a weekday appointment based on cycle progression. After an egg retrieval, patients need to take the day off but usually head back to work the next day.

And there you have it! An expert’s answers to 10 of the most common questions about infertility. To learn more about five free National Infertility Awareness Events, take a 10-question true/false fertility quiz. To learn more about booking a free Fertility Awareness Checkup ($90 value), visit fcionline.com/niaw. Not in the Chicagoland area? Visit resolve.org to find infertility resources in your neck of the woods.

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Disclaimer: The information provided is for educational and informational purposes only and is not intended to diagnose, treat, cure or prevent any disease. Any reader who is concerned about his or her health should contact a physician for advice.

Dr. Nina is a health expert, lifestyle strategist, and respected author, blogger and thought leader in the wellness realm with over 15 years of experience in developing and managing innovative preventive, promotional and rehabilitative programs and services aimed at women, families and communities. A devoted wife, mother and athlete, she enjoys spending quality time with family, hosting dinners and parties, cultural festivals and events, traveling, and exploring the great outdoors through running, hiking and biking. Appreciative of all things beautiful, Dr. Nina is a self-proclaimed lover of food, fashion, and furniture.

About Dr. Nina

Health Expert & Lifestyle Strategist

Dr. Nina Cherie Franklin is a highly sought after and respected author and blogger, speaker, and thought leader in the wellness realm with an impressive history of building innovative preventive, promotional and rehabilitative programs that improve health outcomes and quality of life among people from all walks of life.